Influence of Carbon Dioxide Pneumoperitoneum Environment on Adhesion and Metastasis of a Human Ovarian Cancer Cell Line

Background: This study aimed to explore the adhesion and metastasis capability of the human ovarian cancer cell line SKOV(3) after exposure to a simulated laparoscopic carbon dioxide (CO(2)) pneumoperitoneum environment and the related mechanism.

Methods: SKOV(3) was subjected to a simulated laparoscopic CO(2) pneumoperitoneum environment at various CO(2) pressures (8-12 mmHg) and exposure times (1-3 h). Cell adhesive capacity was determined by a mechanical method. Real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) and immunocytochemical staining were used to examine the mRNA and protein expressions of heparanase (HPSE) and vascular endothelial growth factor C (VEGF-C) in SKOV(3). Cells cultured in a standard environment were used as the control.

Results: The increase of SKOV(3) cell adhesion capability was associated with CO(2) pressure and exposure time. A significantly higher adhesion capability was observed in the group with exposure to 10 mmHg for 2 h over a 48 h period, as compared with the control groups (p < 0.05). The expressions of HPSE and VEGF-C in SKOV(3), which are closely related to metastasis capability, also increased. Significantly higher expressions were observed in the group with exposure to 10 mmHg for 3 h over a 48 h period, as compared with the control groups (p < 0.01).

Conclusions: The adhesion and metastasis capacity of SKOV(3) increased with overexpression of HPSE and VEGF-C and were positively related to CO(2) pressure, exposure, and culture time.